Peripheral Arterial Disease Often Under-Diagnosed and Under-Treated
Peripheral arterial disease (PAD) is a fairly common condition. It affects
an estimated 8 to 10 million people in the United States,
and it puts people at a high risk of heart attack, stroke
and death. Treatment is often quite simple, but a recent study
published in the Journal of the American Medical Association
(JAMA) has pointed out that PAD is frequently under-diagnosed,
leaving people at high risk unnecessarily. This is especially
important news for people with diabetes, who are at higher
risk of PAD than the general population.
a form of atherosclerosis, a hardening or narrowing of the
arteries caused by the buildup of plaque. This plaque buildup
slows down blood flow, increasing the risk of heart attack
and stroke. You may have heard about this type of narrowing
in the arteries of the heart, which is called coronary artery
disease. PAD is the same type of condition, but it occurs
in the arteries of the arms, kidneys, legs and feet.
are the Symptoms?
The main symptom of PAD is leg pain or weakness. At
first, you might feel pain only during physical activity,
such as walking. In its later stages, PAD can become much
more severe, causing disability.
often mistake their leg pain as simply a normal part of aging,
but this is not the case. Most people can control their symptoms
if their PAD is diagnosed and treated.
less common symptoms include:
pain and vomiting
on the feet and lower legs
at Increased Risk?
The following factors increase the risk of PAD:
most commonly diagnosed using a painless measurement called
the ankle-brachial index. Blood pressure is measured in the
arm and then the ankle. A simple calculation determines whether
PAD is present.
Treatment: Readily Available
The JAMA study comprised 6,979 patients aged 70 or
older or patients 50 through 69 years old with a history of
smoking or diabetes. Results of the study, which were published
in September, revealed that PAD is often under-diagnosed.
Additionally, even when study participants had been diagnosed
with PAD, they were not as likely to be treated for it as
people who have cardiovascular disease.
medication is the most common treatment for PAD. For some
people, this may simply mean taking aspirin every day. For
others, a prescription medication may be more effective. The
Food and Drug Administration has approved the use of a drug
called clopidogrel for prevention of heart attack in patients
with PAD. Other treatment may involve regular exercise and
an adjustment in eating habits.
have diabetes, consider discussing your risk of PAD with your
doctor. Treatment is fairly simple for most people, and can
significantly reduce your risk of heart attack and stroke.
Journal of the American Medical Association, 19 September
2001; New England Journal of Medicine, 24 May 2001.